Behavior Change Theories

Abdul-Monaf Al-Jadiry, MD, FRCPsych

Professor of Psychiatry

Behavioral change theories

▪ These theories explain the reasons behind

alterations in individuals' behavioral patterns.

▪ These theories serve to understand better

those factors associated with maximizing

adherence to positive physical activity and

lifestyle behaviors at the individual,

community and population levels.

Theories of behaviour change

• They cite environmental, personal, and behavioral

characteristics as the major factors in behavioral

determination.

▪ These theories have attracted growing attention as the

negative consequences of unhealthy lifestyle behaviors

have become increasingly apparent.

▪ They are pertinent to the development of effective

interventions in the field of health and physical

activity

The Key elements of Behavior Change Key Element Definition Strategies

Threat A danger or a harmful event

of which people may or may

not be aware.

raise awareness

that the threat

exists, focusing on

severity and

susceptibility.

Fear Emotional arousal caused by

perceiving a significant and

personally relevant threat.

Channeling fear in

the appropriate

way, can motivate

people to seek

information, but it

can also cause

people to deny they

are at-risk.

The Key elements of Behavior Change Key Element Definition Strategies

Response

Efficacy

Perception that a

recommended response

will prevent the threat

from happening.

Provide evidence

of examples that

the recommended

response will

avert the threat.

Self-Efficacy An individual’s

perception of or

confidence in their

ability to perform a

recommended

response.

Raise individuals’

confidence that

they can perform

response and help

ensure they can

avert the threat.

Self-efficacy

• Self-efficacy means individual’s impression of their

own ability to perform a demanding or challenging

task such as facing an exam or undergoing surgery.

• Self-efficacy is based on factors like the individual’s

prior success in the tasks, physiological state, and

outside sources of persuasion.

• Self-efficacy is an important element of many of the

theories, including: the Health Belief Model, the Theory of

Planned Behavior and the Health Action Process Approach.

Theories of behavior change

• Understanding behavioral change will improve

the services offered in the areas of:

• health,

• education,

• criminology,

• energy, and

• international development.

General Theories & Models:

• Learning theories/ behavioral analytic

theories of change

• Social learning/ social cognitive theory

• Theory of Reasoned Action

• Theory of Planned Behavior

• Transtheoretical theory/ Stages of Change

Model

• Health Action Process approach

Learning theories/behavior analytic

theories of change

• Derived from the school of behaviorism (Pavlov,

Skinner, Watson)

• These theories utilize learning principles to bring

about behavior change.

• State that complex behavior is learned

gradually through modification of simpler

behaviors.

• As each simple behavior is established

through imitation and reinforcement, the

complex behavior develops.

Learning theories/behavior analytic

theories of change

Techniques and Strategies Used In

Behavior Analysis:.1Chaining:

➢Involves breaking a task down into

smaller components.

➢The simplest or first task in the process is

taught first.

➢Once that task has been learned, the next

task can be taught. This continues until

the entire sequence is chained together.

Learning theories/behavior analytic

theories of changeTechniques and Strategies Used In Behavior

Analysis:

2. Prompting:

➢Involves using prompt to trigger a desired

response.

➢This might involve issues a verbal cue, such as

telling the person what to do, or a visual cue,

such as displaying a picture designed to cue

the response.

Learning theories/behavior analytic

theories of change

Techniques and Strategies Used In

Behavior Analysis:

3. Shaping:

Involves gradually altering a behavior,

rewarding closer and closer

approximations of the desired behavior.

Social learning/ social cognitive theory

▪Social cognitive theory is a learning theory

based on the idea that people learn by

observing others.

▪People learn by observing others, with the

environment, behavior, and cognition all as

the chief factors in influencing development in

a reciprocal triadic relationship.

▪For example, each behavior witnessed can

change a person's way of thinking (cognition).

Similarly, the environment one is raised in

may influence later behaviors.

Social learning/ social cognitive theory

Bandura's schema shows how the reproduction of

an observed behavior is influenced by the

interaction of the following three determinants:

•Personal: Whether the individual has high or

low self-efficacy toward the behavior.

•Behavioral: The response an individual

receives after performing a behavior .

•Environmental: Aspects of the environment or

setting that influence the individual's ability to

successfully complete a behavior.

Theory of Reasoned Action

• The theory is one of the three classic

models of persuasion.

• The theory aims to explain the

relationship between attitudes and

behaviors within human action.

• How individuals will behave based on

their pre-existing attitudes and behavioral

intention.

Theory of Reasoned Action

▪ Individual's decision to engage in a

particular behavior is based on the

outcomes the individual expects will

come as a result of performing the

behavior.

▪ Intention is an important factor in

determining behavior and behavioral change.

▪ Personal attitude and social pressure shape

intention.

Theory of Planned Behavior

• Represents an expansion upon the theory of

reasoned action.

• It states that behavior performance is

proportional to the amount of control an

individual possesses over the behavior and the

strength of the individual's intention in

performing the behavior.

• The theory holds that only specific attitudes

toward the behavior in question can be

expected to predict that behavior.

• Perceived behavioral control influences

intentions.

Theory of Planned Behavior

• Perceived behavioral control refers to people's

perceptions of their ability to perform a given

behavior. These predictors lead to intention.

• The more favorable the attitude and the

subjective norm, and the greater the perceived

control the stronger should the person’s

intention to perform the behavior in question.

• Intended to cover cases in which a person is not

in control of all factors affecting the actual

performance of a behavior.

Health Action Process approach

• Designed as a sequence of two continuous self-

regulatory processes:

A.a goal-setting phase (motivational phase, intention)

B. a goal-pursuit phase (volition), subdivided into:

➢ a pre-action phase and (A)

➢ an action phase (B)

• Motivational self-efficacy, outcome-expectancies and

risk perceptions are assumed to be predictors of

intentions, the motivational phase.

• The effects of intentions are assumed to be mediated

by planning, Action phase (B).

Stage Theories of Behavior Change

These theories propose an integrated stage-based

model in which behavior change is viewed as a

cyclical process that involves five stages of:

• awareness of the problem and a need to change

• motivation to make a change

• skill development to prepare for the change

• initial adoption of the new activity or behavior a

• maintenance of the new activity and integration

into the lifestyle.

Stages of Change Model(Transtheoretical Model)

• Behavioral change is a five-step process.

• The five stages, between which individuals may

oscillate before achieving complete change, are:

➢Precontemplation,

➢Contemplation,

➢Preparation,

➢Action, and

➢Maintenance.

Stage Theories of Behaviour Change

Precontemplation:

In this stage, there is no intent on the part of the

individual to change his or her behavior in the

foreseeable future.

Contemplation:

People are aware that a problem exists and are

seriously considering taking some action to

address the problem.

Stage Theories of Behaviour Change

Preparation:,

Involves both intention to change and some

behaviour, usually minor, and often meeting

with limited success

Action:

Individuals actually modify their behavior in

order to overcome their problems or to meet

their goals.

Stage Theories of Behaviour Change

Maintenance:

People work to prevent relapse and

consolidate the gains attained in the action

stage.

Stage Theories of Behaviour Change

• The pattern of movement through the 5 stages

is neither unitary or linear, but rather, cyclical,

involving a pattern of :

- adoption ,

- maintenance,

- relapse, and

- readoption over time.

Applications of Stage Theories of Behaviour

Change

• Health Care

• Education

• Criminology

• Energy Consumption Behaviour

Health Care

• Behavioral change theories explain health-

related behaviors and provide insight into

methods that would encourage individuals to

develop and maintain healthy lifestyles.

• Include the development of programs

promoting active lifestyles and programs

reducing the spread of diseases like AIDS

Health Care

Behavioral change theories has been applied

successfully in:

▪ psychotherapeutic interventions,

▪ smoking cessation,

▪ substance abuse programs.

▪ understanding patterns of physical

activity participation and exercise

adherence

Health

• Models of behavior change specific to health

applications include:

➢The Health Belief? Health Action Model,

➢Relapse Prevention Model,

➢the Health Action Process Approach, and

➢the I-Change Model.

Health Care

• The Health Belief Model (Health Action

Model), states that individuals will alter health-

related behavior according to the perceived

severity of the threat to their health.

• The Relapse Prevention Model concentrates on

promoting prolonged healthy behavior by

making distinctions between lapses and

relapses in an attempt to encourage individuals

to maintain healthy lifestyles.

Health Care

• The I- Change Model:

An integrated Model for explaining motivational

and behavioral change derived from the:

Attitude – Social influence – Self-Efficacy Model.

Assumes that three phases in the behavioral

change process :

1. Awareness

2. Motivation

3. Action.

Education

• Behavioral change theories provide insight into

the formulation of effective teaching methods

that tap into the mechanisms of behavioral

change.

• Social Learning Theory and Theory of Planned

Behavior, were developed as attempts to

improve health education.

Criminology

• The general theories of behavioral change suggest

possible explanations to criminal behavior and

methods of correcting deviant behavior.

• Understanding of behavioral change can facilitate

the adoption of effective correctional methods in

policy-making.

• Specific theories that have been applied to

criminology include the Social Learning

Theory and Differential Association Theory .

Criminology

The understanding that deviant behavior like

stealing may be learned.

A behavior resulting from reinforcers like

hunger satisfaction that are unrelated to

criminal behavior, can aid the

development of social controls that

address this underlying issue rather than

merely the resultant behavior.

Energy

• Intervention programs aimed at the change of

energy consumption patterns need to take into

account that behavioral change is best achieved

and maintained if supported by tailored

information and changes in context, for example

supportive social networks, policies or

technologies.

• Focus should be on broadening social interaction,

lifestyles, norms and values as well as technologies and

policies—all enabling or constraining behavioral

change, and not only individual behavior

Rogers Stage-Based Theory:

▪ Explains how new ideas or innovations are

disseminated and adopted at the community and

population levels.

▪ Rogers identified five distinct stages in the

process of diffusion of any new initiative or

innovation:

➢knowledge,

➢persuasion,

➢decision,

➢implementation,

➢confirmation.

Thank You